The present application discloses systems, apparatuses, and methods directed to an interactive, intracardiac signal simulator that emulates the electrical behavior of a patient's heart. In particular, the disclosed interactive, intracardiac signal simulator may be used in the course of a simulated electrophysiology study (EP study).
An EP study is an invasive procedure used to evaluate a patient's heart rhythms. Motivations for conducting EP studies include evaluating patient symptoms such as light-headedness, fainting, weakness, dizziness, palpitations, or other cardiac rate or rhythmic issues, locating a source of a patient's cardiac rhythm problem, assessing the therapeutic effectiveness of one or more medications to treat an arrhythmia, and/or to deliver therapeutic treatment for a cardiac rhythmic disorder. During the EP study, wire electrodes are inserted through a vein in, e.g., the patient's groin or neck. The electrodes track the vein to reach the interior of the patient's heart, where the electrodes are used to measure the patient's cardiac electrical activity. Electrical stimulation signals may also be transmitted to the patient's heart to initiate suspected or previously-observed abnormal heart rhythm disorders for evaluation. Sometimes an abnormal rhythm is intentionally stimulated by the electrophysiologist to identify the underlying, structural problem with the patient's heart or to evaluate the effectiveness of a pharmaceutical therapy. The electrophysiologist may also map the electrical activity of the patient's cardiac tissue to locate a source of the patient's arrhythmia. If a source location of the arrhythmia is identified, a corrective procedure, such as an ablation, may be performed in an effort to resolve the problem. Since the findings of the EP study provide insight into the electrical behavior of the patient's heart, those findings may assist the electrophysiologist in identifying additional therapeutic measures to address the patient's conditions.
Clinically, a cardiac electrophysiologist (the operator) performs the EP study by placing multi-electrode catheters in the heart for recording intracardiac electrical signals, also referred to as intracardiac electrograms (IEGMs). The catheters are connected to an electrophysiology recording system (also referred to herein as “an EP recording system”). Commercial electrophysiology recording systems include, among others, Cardiolab™ offered by GE Healthcare, and EP-WorkMate™ Claris™, offered by St. Jude Medical, Inc. Examples of electrophysiology recording systems are disclosed in U.S. Patent Publication No. US 2015/0058032, entitled “System for Sharing Data Within an Electrophysiology Lab,” published on Feb. 26, 2015, and U.S. Patent Publication No. US 2013/0041243, entitled “User Interface Devices for Electrophysiology Lab Diagnostic and Therapeutic Equipment,” published on Feb. 14, 2013, the contents of which are incorporated herein by reference in their entireties. In addition to recording and reviewing signals, the operator interacts with the patient's heart by pacing (delivery of low voltage pulses through catheters to specific cardiac regions), infusion of medications, and/or cardioversion (delivery of one or more electrical shocks to terminate dangerous arrhythmias). The goal of the EP study is to test the patient's cardiac electrical system and to diagnose its abnormalities (arrhythmias). In many cases, the EP study is a prelude to a corrective procedure, such as ablation.
The ability to perform and interpret an EP study is a necessary skill for electrophysiologists. While there is no perfect substitute for performing tests and maneuvers during an EP study conducted on a human patient, logistical and safety considerations commonly preclude a thorough practice in the course of a routine case. As a result, the operator may gradually lose his or her skills needed to deal with difficult cases.
Electrophysiology lab staff members, such as nurses and technicians, play integral roles in an EP study. The staff members are required to possess a very good working knowledge of the intracardiac signals and pacing maneuvers used in EP studies. Traditionally, staff members learn EP study skills on-the-job, over the course of many years, which can be both inefficient and potentially hazardous for patients.
Acquiring and maintaining complex skill sets can be facilitated by using simulators, which allow the operator to practice in a safe and controlled setting. For example, flight simulators are commonly used in the aviation industry for pilot training and are considered a valuable part of pilot training programs. More recently, simulators have entered the medical field and are gradually becoming an integrated part of clinical skill training and competency assessment.
Currently-available electrocardiography (ECG) simulators simply play back a previously-recorded set of signals. Such passive systems are not sufficient for simulating intracardiac signals because they lack the ability to interact with the cardiac electrical system in real-time, which can be an important component of an EP study and an EP study training session.